本文選題：老年人 + 腦血流量��； 參考：《中國人民解放軍醫(yī)學院》2017年碩士論文

【摘要】：目的:利用3D-pCASL (3D-pseudocontinuous arterial spin labeling,三維準連續(xù)動脈自旋標記)技術探究80歲以上高齡老年男性腦血流灌注特點。材料與方法:對52例80歲以上無癥狀、無明確既往神經(jīng)系統(tǒng)疾病的高齡老年男性進行磁共振常規(guī)掃描及3D-pCASL掃描,PLD時間(post labeling delay time,延遲標記時間)選取1525毫秒以及2525毫秒,利用SPM12軟件分別測量左右大腦半球、前后循環(huán)rCBF(relative cerebral blood flow,相對腦血流量)值以及額葉、頂葉、顳葉、枕葉、基底節(jié)區(qū)、小腦的rCBF值。采用兩獨立樣本t檢驗的統(tǒng)計學方法比較受試者左右大腦半球rCBF值的差異,前后循環(huán)rCBF值的差異,以及各個腦葉之間及基底節(jié)區(qū)rCBF值的差異。結果:52例受試者在PLD時間分別為1525ms及2525ms時,左側大腦半球與右側大腦半球相比,rCBF值差異均不具有統(tǒng)計學意義(p=0.259, p=0.630);在PLD時間為1525ms時,前循環(huán)的rCBF值高于后循環(huán)rCBF值,差異具有統(tǒng)計學意義(p=0.019),而在PLD時間為2525ms時,二者rCBF值差異不具有統(tǒng)計學意義(p=0.929);基底節(jié)區(qū)與其他腦葉相比,rCBF值低于各個腦葉,差異具有統(tǒng)計學意義(p=0.001,p=0.032,p=0.012,p=0.026, p=0.007),而除基底節(jié)區(qū)之外的腦葉間兩兩相比,rCBF值差異均不具有統(tǒng)計學意義。結論:3D-pCASL技術利用多個PLD時間探究老年人腦血流灌注的特點,并可以此為基礎,更加準確的評價老年患者的異常腦血流灌注變化;3D-pCASL技術可作為評估老年人腦血流灌注的影像學指標,為臨床診斷提供依據(jù)。目的:探究3D-pCASL技術對80歲以上老年人后循環(huán)缺血的研究價值,對老年人PCI(posterior circulation ischemia,后循環(huán)缺血)的臨床診斷提供影像學依據(jù)。材料與方法:對80歲以上臨床診斷為PCI的老年男性20例以及正常老年男性33例分別進行磁共振常規(guī)掃描及3D-pCASL掃描,PLD時間選取1525毫秒以及2525毫秒,利用SPM12軟件分別測量其左側枕葉、右側枕葉、左側小腦、右側小腦rCBF值。采用獨立樣本t檢驗及秩和檢驗比較在兩個PLD時間病例組與對照組前后循環(huán)rCBF的差異,病例組與對照組雙側枕葉、雙側小腦rCBF的差異,以及比較病例組與對照組在兩個PLD時間的時間間隔中雙側枕葉、雙側小腦rCBF增量(△rCBF)的差異。結果:病例組在PLD時間為1525ms及2525ms時,前循環(huán)的rCBF值均高于后循環(huán)rCBF值,而對照組僅在1525ms時前循環(huán)的rCBF值均高于后循環(huán)rCBF值,差異具有統(tǒng)計學意義(p=0.000, p=0.000, p=0.025);病例組在兩個PLD時間時雙側枕葉、雙側小腦的rCBF值均低于對照組,差異均具有統(tǒng)計學意義(p=0.003, p=0.002,p=0.000,p=0.001,p=0.000, p=0.001, p=0.002, p=0.014)。結論:高年齡段老年人因后循環(huán)血流慢,3D-pCASL技術需采用多個PLD時間來判斷PCI的有無;3D-pCASL技術對檢測后循環(huán)rCBF下降敏感,可作為老年人后循環(huán)卒中預警手段之一。
[Abstract]:Objective: to investigate the cerebral perfusion characteristics of aged men aged over 80 years by 3D-pCASL (3D pseudo continuous arterial spin labeling,) technique. Materials and methods: 1525 Ms and 2525 Ms were performed on 52 asymptomatic elderly men aged over 80 years without prior neurological diseases. The (post labeling delay time, delay time of PLD and 3D-pCASL scan were 1525 Ms and 2525 Ms, respectively. SPM12 software was used to measure the rCBF (relative cerebral blood flow, relative to cerebral blood flow in left and right cerebral hemispheres, and in frontal lobe, parietal lobe, temporal lobe, occipital lobe, basal ganglia region and cerebellum. The difference of rCBF between left and right cerebral hemispheres, the difference of rCBF between anterior and posterior circulation, and the difference of rCBF between different lobes and basal ganglia were compared by using two independent sample t test methods. Results there was no significant difference in rCBF between the left and right hemispheres when the 1525ms and 2525ms were 1525ms and 2525ms, respectively (p0.259, p0.630), and the rCBF of the anterior circulation was higher than that of the posterior circulation when the PLD-time was 1525ms, and there was no significant difference between the left hemisphere and the right hemisphere (p0.259, p0.630). The difference was statistically significant (p0. 019), but there was no significant difference in rCBF between the two groups (p0. 929), and the basal ganglia was lower than that in the other lobes (p 0. 929), and the RCBF of basal ganglia was lower than that of other lobes. The difference was statistically significant (p0. 001, p0. 032, p0. 012, p0. 026, p0. 007), but there was no significant difference in rCBF between the two lobes except the basal ganglia. Conclusion using multiple PLDs to explore the characteristics of cerebral blood perfusion in the elderly by using the technique of: 3D-pCASL, it can be used as a basis. The 3D-pCASL technique can be used as an imaging index to evaluate cerebral blood perfusion in elderly patients and provide evidence for clinical diagnosis. Objective: to explore the value of 3D-pCASL in the study of posterior circulation ischemia in elderly patients over 80 years old, and to provide imaging evidence for the clinical diagnosis of posterior circulation ischemia in elderly patients. Materials and methods: 1525 milliseconds and 2525 milliseconds were selected for conventional MRI scan and 3D-pCASL scan for 20 elderly men over 80 years old and 33 normal elderly men, respectively. The rCBF values of left occipital lobe, right occipital lobe, left cerebellum and right cerebellum were measured by SPM12 software. T test and rank sum test were used to compare the difference of rCBF between the two PLD groups before and after circulation, and between the case group and the control group in bilateral occipital lobe and cerebellar rCBF. The differences of rCBF increment (rCBF) in bilateral occipital lobe and cerebellum between two PLD time intervals were compared between the case group and the control group. Results: the rCBF values of the anterior circulation were higher than those of the posterior circulation when the PLD time was 1525ms and 2525ms, while in the control group, the rCBF value of the anterior circulation was higher than that of the posterior circulation only at the time of 1525ms. The rCBF values of both occipital lobes and cerebellum in the two PLD groups were significantly lower than those in the control group (p0. 003, p0. 002p0. 000 P0. 000, p0. 001, p0. 002, p0. 014), and the difference was statistically significant (p0. 003, p0. 000, p0. 001p0.000, p0. 001, p0. 002, p0. 014). Conclusion: the 3D-pCASL technique in the elderly with high age needs to use multiple PLD time to determine the sensitivity of PCI to detecting the decrease of rCBF, and it can be used as one of the early warning methods for post-circulatory stroke in the elderly.
【學位授予單位】：中國人民解放軍醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3;R445.2

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